Artificial nutrition and hydration in the last week of life in cancer patients. A systematic literature review of practices and effects
Open Access
- 3 January 2011
- journal article
- review article
- Published by Elsevier BV in Annals Of Oncology
- Vol. 22 (7), 1478-1486
- https://doi.org/10.1093/annonc/mdq620
Abstract
Background: The benefits and burdens of artificial nutrition (AN) and artificial hydration (AH) in end-of-life care are unclear. We carried out a literature review on the use of AN and AH in the last days of life of cancer patients. Materials and methods: We systematically searched for papers in PubMed, CINAHL, PsycInfo and EMBASE. All English papers published between January 1998 and July 2009 that contained data on frequencies or effects of AN or AH in cancer patients in the last days of life were included. Results: Reported percentages of patients receiving AN or AH in the last week of life varied from 3% to 53% and from 12% to 88%, respectively. Five studies reported on the effects of AH: two found positive effects (less chronic nausea, less physical dehydration signs), two found negative effects (more ascites, more intestinal drainage) and four found also no effects on terminal delirium, thirst, chronic nausea and fluid overload. No study reported on the sole effect of AN. Conclusions: Providing AN or AH to cancer patients who are in the last week of life is a frequent practice. The effects on comfort, symptoms and length of survival seem limited. Further research will contribute to better understanding of this important topic in end-of-life care.Keywords
This publication has 66 references indexed in Scilit:
- Cultural Beliefs About a Patient’s Right Time to Die: An Exploratory StudyJournal of General Internal Medicine, 2009
- An evaluation of the implementation of a programme to improve end-of-life care in nursing homesPalliative Medicine, 2009
- Quality of life at the end of lifeHealth and Quality of Life Outcomes, 2007
- The development of the EORTC QLQ-C15-PAL: A shortened questionnaire for cancer patients in palliative careEuropean Journal Of Cancer, 2006
- Patients' and Relatives' Perceptions About Intravenous and Subcutaneous HydrationJournal of Pain and Symptom Management, 2005
- Terminal cancer patients' wishes and influencing factors toward the provision of artificial nutrition and hydration in TaiwanJournal of Pain and Symptom Management, 2004
- End-of-Life Decision-Making in the Hospital: Current Practice and Future ProspectsJournal of Pain and Symptom Management, 1999
- Dehydration and the dying patientJournal of Pain and Symptom Management, 1995
- The use of hypodermoclysis for rehydration in terminally ill cancer patientsJournal of Pain and Symptom Management, 1994
- Character of terminal illness in the advanced cancer patient: Pain and other symptoms during the last four weeks of lifeJournal of Pain and Symptom Management, 1990